Biologic/Regenerative Medicine

The use of the body’s own cells is one of the most exciting and potentially disruptive forces in orthopaedics today. The potential to reverse the debilitating effects of osteoarthritis or to accelerate the healing of a tendon or ligament has long been the ultimate dream of orthopaedic field. Though we have many questions unanswered, the early successes of biologic medicine have caused an explosion interest in the field. An important discussion to have with your treating physician at Southern Orthopaedics regards the amount of evidence or support in the medical literature that exists with respect to a certain “biologic” treatment. For example, many injections are labeled as “stem cells” when they actually contain little, if any, viable stem cells.

Currently in the United States, the only 2 FDA approved orthopaedic biologic options are for PRP (platelet rich plasma) and autologous mesenchymal stem cells (MSCs).

PRP therapy involves taking a small amount of peripheral blood, then separating out and concentrating the platelets and the plasma that contain many of the body’s growth and healing factors. The injection is done in the office and different physicians have varying post injection rehabilitation protocols. Unfortunately, no major insurance carriers cover PRP injections so the cost varies among physicians.

The second approved biologic treatment is mesenchymal stem therapy. The only two approved methods to obtain the body’s stem cells are either through fat (such as with a liposuction procedure) or through the bone marrow. With the bone marrow procedure, bone marrow is removed from the back of the pelvis and then separated out and injected into the affected joint. As with PRP, no insurance carriers cover mesenchymal stem cell therapy.

Additional information, including the American Academy of Orthopaedic Surgeons Consensus Statement on the issue, can be found in these articles.